Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1306852454 |
---|---|
Provider Name | Dr. Christie Counsman Eberhardt |
First Address | Chugiak, AK 99567-6743 |
Second Address | Chugiak, AK 99567-6743 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 08/07/2007 |